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WESTERN NEW YORK MEDICAL PRACTICE, P.C.

WESTERN NEW YORK MEDICAL PRACTICE, P.C.

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Company Details

Name:	WESTERN NEW YORK MEDICAL PRACTICE, P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Active
Date of registration:	01 Mar 2011 (14 years ago)
Entity Number:	4061292
ZIP code:	14617
County:	Monroe
Place of Formation:	New York
Address:	ATTN: GENERAL COUNSEL, 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY, United States, 14617
Principal Address:	100 KINGS HIGHWAY SOUTH, ROCHESTER, NY, United States, 14617

Contact Details

Phone +1 315-597-8828

Phone +1 585-463-3870

Phone +1 315-789-5061

Phone +1 585-342-2410

Phone +1 585-571-2025

Phone +1 585-922-9770

Phone +1 585-637-7200

Phone +1 585-899-3454

Phone +1 585-335-9840

Phone +1 585-389-6040

Phone +1 607-587-8143

Phone +1 585-392-9100

Phone +1 585-225-5252

Phone +1 585-266-4000

Phone +1 585-444-0058

Phone +1 585-266-0061

Phone +1 585-336-5320

Phone +1 585-385-0590

Phone +1 585-227-4000

Phone +1 585-442-5320

Phone +1 585-244-0332

Phone +1 585-394-1960

Phone +1 585-454-6720

Phone +1 585-249-1340

Phone +1 315-787-5100

Phone +1 585-201-7793

Phone +1 585-922-0400

Phone +1 585-922-8915

Phone +1 585-922-0374

Phone +1 315-787-5155

Phone +1 315-462-1170

Phone +1 585-394-4920

Phone +1 315-986-1336

Phone +1 585-613-3099

Phone +1 585-922-5550

Phone +1 315-332-8041

Phone +1 585-922-2900

Phone +1 585-383-8830

Phone +1 585-544-2474

Phone +1 716-434-9141

Phone +1 585-266-2010

Phone +1 585-922-3787

Phone +1 585-342-0140

Phone +1 585-232-2980

Phone +1 585-336-5000

Phone +1 585-266-1000

Phone +1 585-742-1135

Phone +1 585-381-1860

Phone +1 585-266-3300

Phone +1 315-359-2661

Phone +1 315-462-0447

Phone +1 315-462-5711

Phone +1 585-922-4442

Phone +1 585-924-2100

Phone +1 585-338-2700

Phone +1 585-393-3515

Phone +1 585-453-7120

Phone +1 585-343-2611

Phone +1 585-554-3119

Phone +1 585-243-2020

Phone +1 607-324-8000

Phone +1 585-948-8077

Phone +1 585-412-6491

Phone +1 315-462-1495

Phone +1 585-243-5790

Phone +1 585-922-5840

Phone +1 585-467-8346

Phone +1 585-321-0110

Phone +1 315-359-2696

Phone +1 315-789-5758

Phone +1 585-265-0800

Phone +1 585-872-2273

Phone +1 585-293-7300

Phone +1 607-324-5404

Phone +1 585-429-5330

Phone +1 585-385-5555

Phone +1 585-899-3450

Shares Details

Shares issued 200

Share Par Value 1

Type PAR VALUE

Chief Executive Officer

Name	Role	Address
ROBERT R. MAYO, M.D.	Chief Executive Officer	100 KINGS HIGHWAY SOUTH, ROCHESTER, NY, United States, 14617

DOS Process Agent

Name	Role	Address
WESTERN NEW YORK MEDICAL PRACTICE, P.C.	DOS Process Agent	ATTN: GENERAL COUNSEL, 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY, United States, 14617

Unique Entity ID

Unique Entity ID:

XL3DHKCG9L23

UEI Expiration Date:

2026-06-06

Business Information

Doing Business As:

WESTERN NEW YORK MEDICAL PRACTICE PC

Activation Date:

2025-06-10

Initial Registration Date:

2024-05-07

National Provider Identifier

NPI Number:

1205643400

Certification Date:

2024-12-12

Link:

View on NPI website

Authorized Person:

Name:

NICHOLE S HOLDER

Role:

DIRECTOR - PAYER ENROLLMENT

Phone:

5859220293

Taxonomy:

Selected Taxonomy:

332H00000X - Eyewear Supplier

Is Primary:

Selected Taxonomy:

156FX1800X - Optician

Is Primary:

Yes

Contacts:

Phone:

+1 585-544-6680

History

Start date	End date	Type	Value
2017-06-16	2021-03-03	Address	ATTN: GENERAL COUNSEL, 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY, 14617, USA (Type of address: Service of Process)
2013-03-21	2017-06-16	Address	1425 PORTLAND AVENUE, ROCHESTER, NY, 14621, USA (Type of address: Chief Executive Officer)
2013-03-21	2017-06-16	Address	1425 PORTLAND AVENUE, ROCHESTER, NY, 14621, USA (Type of address: Principal Executive Office)
2011-03-01	2024-06-13	Shares	Share type: PAR VALUE, Number of shares: 200, Par value: 1
2011-03-01	2017-06-16	Address	ATTN: GENERAL COUNSEL, 1425 PORTLAND AVENUE, ROCHESTER, NY, 14621, USA (Type of address: Service of Process)

Filings

Filing Number	Date Filed	Type	Effective Date
210303061425	2021-03-03	BIENNIAL STATEMENT	2021-03-01
190325060267	2019-03-25	BIENNIAL STATEMENT	2019-03-01
170616006227	2017-06-16	BIENNIAL STATEMENT	2017-03-01
130321006078	2013-03-21	BIENNIAL STATEMENT	2013-03-01
130123000236	2013-01-23	CERTIFICATE OF AMENDMENT	2013-01-23

Tax Exempt

Employer Identification Number (EIN) :

61-1654232

In Care Of Name:

% GENERAL COUNSEL

Classification:

Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)

Ruling Date:

2013-02

Deductibility:

Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letters